February 11, 2020 - The Governor’s budget proposes $2.3 billion for the Department of State Hospitals (DSH) in 2020‑21—an increase of $232 million (11 percent) from the revised 2019‑20 level. In this report, we assess three specific DSH proposals and offer recommendations for legislative consideration.
February 9, 2015 - This report examines the budget of the Department of State Hospitals (DSH), which provides inpatient mental health services to patients in DSH’s eight facilities. It provides an overview of the various components of the department’s budget, and details how the department develops its annual budget requests. The report finds several shortcomings with the current budgeting process. To address these, the report provides recommendations for the Legislature to consider.
March 1, 2012 - The Governor’s budget plan proposes to eliminate DMH and create a new Department of State Hospitals (DSH), shifting the remaining community mental health programs to various departments. This new structure would allow the administration to better focus on the fiscal and programmatic issues unique to state hospitals. In 2008-09, the Office of State Audits and Evaluations (OSAE) conducted an audit which outlined the problems state hospitals experienced, concluding that staffing did not adequately reflect hospital workload, funding was not sufficient for annual operating expenditures, and that state hospitals were not efficiently using their staff. Similarly in a 2011 self-audit, DMH found that many of the same problems from the 2008 audit remained. We concur with both audit teams’ assessments. In this brief report, therefore, we recommend an audit be conducted that looks at a number of issues, including state hospital budgeting practices, the fiscal controls being put in place, and the level of vacancies and their impact on the state budget and on hospital performance. We recommend this added oversight with respect to state hospitals should take place regardless of the Legislature’s decision on the creation of a new DSH.
February 22, 2017 - In this web post, we provide an overview of the Department of State Hospitals (DSH) and the level of funding proposed for the department in the Governor’s 2017-18 budget. We also assess and make recommendations on four specific DSH budget proposals: (1) a $250 million shift in inpatient psychiatric programs from DSH to the California Department of Corrections and Rehabilitation, (2) a $10.5 million proposal to activate 60 beds for Incompetent to Stand Trial patients in the Kern County Jail, (3) an $ 8 million dollar funding increase to staff units designed specifically for violent patients, and (4) a $6.2 million General Fund loan for DSH-Napa earthquake repairs.
March 1, 2017 - In this web post, we provide an overview of the California Department of Corrections and Rehabilitation (CDCR) and the level of funding proposed for the department in the Governor's 2017-18 budget. We also assess and make recommendations on various CDCR budget proposals, including a $12.6 million proposed augmentation related to changes in the adult inmate and parolee populations. In addition, we assess and provide recommendations on three proposals related to inmate mental health care: a $250 million shift of inpatient psychiatric programs from the Department of State Hospitals to CDCR, an $11.4 million proposal to convert 74 existing outpatient mental health beds into inpatient psychiatric program beds, and a $112 million proposal to construct 100 additional Mental Health Crisis Beds. Finally, we assess and provide recommendations on five other CDCR proposals: an $11.7 million proposal to install video surveillance cameras, the delayed activation of an infill facility, a proposal to reduce the department’s budget by $8.3 million to reflect housing unit conversions and the reallocation of health care access staff, a $299,000 proposal to modify a fence at a minimum support facility, and proposed budget trailer legislation related to California Prison Industry Authority employee retiree health benefits.
March 3, 2017 - In this web post, we provide an overview of the Federal Receiver for Inmate Medical Services, who maintains direct control over inmate medical care provided in California Department of Corrections and Rehabilitation (CDCR) facilities, and the level of funding proposed for inmate medical services in the Governor’s 2017-18 budget. We also assess and make recommendations on four specific Receiver budget proposals: (1) an $8.9 million augmentation related to medication management, (2) a $3.1 million augmentation related suicide watch, (3) a $5.4 million augmentation related to health care appeals, and (4) a $2 million augmentation related to managing health care equipment.
February 12, 2015 - This report analyzes the Governor's 2015-16 state health program budget proposals. In the report, we review trends in the major health programs since 2007-08 (the last budget developed before the most recent recession), analyze the Governor's proposed restructuring of the managed care organization (MCO) tax, and describe the uncertainty regarding continued federal funding for the Children's Health Insurance Program (CHIP). The report also includes an analysis of the Department of State Hospitals budget and an analysis of the Governor's proposals to improve quality and increase staffing for the Licensing and Certification (L&C) Program administered by the Department of Public Health.
January 9, 2020 - We reviewed the proposed memorandum of understanding (MOU) for Bargaining Unit 18 (Psychiatric Technicians). This review is pursuant to Section 19829.5 of the Government Code.
Corrected 1/10/2020: Changed Figure 3 and reference to the figure in text.